计算机化认知训练对老年抑郁症患者情绪、认知及血清脑源性神经营养因子水平的影响——一项初步随机对照试验
Effect of computerized cognitive training on mood, cognition, and serum brain-derived neurotrophic factor level in late-life depression - a pilot randomized controlled trial.
作者信息
Ma Suk Ling, Tang Katsie Tung, Lau Niki Cheuk Ting, Chiu Clement Lek Hin, Lin Cuichan, Lam Linda Chiu Wa, Lee Allen Ting Chun
机构信息
Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
出版信息
Front Psychiatry. 2024 Jan 17;14:1287822. doi: 10.3389/fpsyt.2023.1287822. eCollection 2023.
BACKGROUND
The aim of this pilot randomized controlled trial was to test the feasibility of a computerized cognitive training targeting executive dysfunction in late-life depression and to investigate its impact on mood, cognition, and brain-derived neurotrophic factor (BDNF) levels.
METHODS
A total of 28 community-living Chinese individuals aged 55-75 with moderate-to-severe depression and cognitive symptoms (but without mild cognitive impairment or dementia) were recruited from a community centre in Hong Kong. Participants were randomly allocated to either the experimental (receiving computerized cognitive training) or the control group (receiving computer-based health education). Both programs lasted for one hour and were conducted twice a week for 6 weeks at the community centre. We assessed mood using the Hamilton Rating Scale for Depression (HAM-D) and Patient Health Questionaire-9 (PHQ-9), cognition using the Montreal Cognitive Assessment (MoCA), and serum BDNF levels at baseline and follow-up. We performed repeated measures analysis of variance to compare the differences in outcome changes between groups and correlation analysis to test if changes in mood and cognition correlated with changes in BDNF level.
RESULTS
Our sample had a mean age of 66.8 (SD = 5.3) years, a mean HAM-D score of 19.4 (SD = 7.5), and a mean PHQ-9 score of 18.0 (SD = 6.3). No adverse effects were reported. Significant differences were observed between the experimental and control groups in changes in HAM-D (-8.4 vs. -2.9; group difference = -5.5; = 0.01), PHQ-9 (-6.6 vs. -0.6; -6.0; < 0.001), MoCA (1.4 vs. -1.3; 2.7; = 0.001), and serum BDNF levels (in pg/ml; 2088.3 vs. -3277.4; 5365.6; = 0.02). Additionally, changes in HAM-D, PHQ-9, and MoCA scores correlated significantly with changes in BDNF level.
CONCLUSION
With computerized cognitive training improving mood and cognition and increasing serum BDNF levels in 6 weeks, it may serve as a safe and effective evidence-based alternative or adjuvant treatment for late-life depression.
CLINICAL TRIAL REGISTRATION
https://www.chictr.org.cn/indexEN.html, identifier ChiCTR1900027029.
背景
这项试点随机对照试验的目的是测试针对老年抑郁症患者执行功能障碍的计算机化认知训练的可行性，并研究其对情绪、认知和脑源性神经营养因子（BDNF）水平的影响。
方法
从香港的一个社区中心招募了28名年龄在55 - 75岁之间、患有中度至重度抑郁症且有认知症状（但无轻度认知障碍或痴呆）的社区居住的中国人。参与者被随机分配到实验组（接受计算机化认知训练）或对照组（接受基于计算机的健康教育）。两个项目均持续1小时，每周在社区中心进行两次，共进行6周。我们在基线和随访时使用汉密尔顿抑郁评定量表（HAM - D）和患者健康问卷 - 9（PHQ - 9）评估情绪，使用蒙特利尔认知评估量表（MoCA）评估认知，并检测血清BDNF水平。我们进行重复测量方差分析以比较两组结果变化的差异，并进行相关分析以检验情绪和认知的变化是否与BDNF水平的变化相关。
结果
我们的样本平均年龄为66.8（标准差 = 5.3）岁，平均HAM - D评分为19.4（标准差 = 7.5），平均PHQ - 9评分为18.0（标准差 = 6.3）。未报告不良反应。实验组和对照组在HAM - D变化（-8.4对 -2.9；组间差异 = -5.5；P = 0.01）、PHQ - 9变化（-6.6对 -0.6；-6.0；P < 0.001）、MoCA变化（1.4对 -1.3；2.7；P = 0.001）和血清BDNF水平（pg/ml；2088.3对 -3277.4；5365.6；P = 0.02）方面存在显著差异。此外，HAM - D、PHQ - 9和MoCA评分的变化与BDNF水平的变化显著相关。
结论
计算机化认知训练在6周内改善了情绪和认知，并提高了血清BDNF水平，它可能是一种安全有效的基于证据的老年抑郁症替代或辅助治疗方法。
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